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Area Deprivation and Respiratory Morbidities in Children with Bronchopulmonary Dysplasia
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  • Emma Banwell,
  • Joseph Collaco,
  • Gabriela Oates,
  • Jessica Rice,
  • Lucia Juarez,
  • lisa young,
  • Sharon McGrath-Morrow
Emma Banwell
University of Pennsylvania

Corresponding Author:[email protected]

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Joseph Collaco
Johns Hopkins Medical Institutions
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Gabriela Oates
University of Alabama at Birmingham
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Jessica Rice
University of Pennsylvania
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Lucia Juarez
The University of Alabama at Birmingham School of Medicine
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lisa young
University of Pennsylvania
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Sharon McGrath-Morrow
University of Pennsylvania
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Introduction: Infants and children diagnosed with BPD have a higher likelihood of recurrent hospitalizations and asthma-like symptoms. Socio-environmental factors that influence frequency and severity of pulmonary symptoms in these children during the pre-school age are poorly under-stood. In this study, we used the Area Deprivation Index (ADI) to evaluate the relationship between the socio-environmental exposures in children with BPD and respiratory outcomes during the first few years of life. Methods: A registry of subjects recruited from outpatient BPD clinics at Johns Hopkins University (n=909) and the Children’s Hospital of Philadelphia (n=125) between January 2008 and October 2021 was used. Subjects were separated into tertiles by ADI scores aggregated to ZIP codes. Care-giver questionnaires were used to assess the frequency of respiratory morbidities and acute care usage for respiratory symptoms. Results: The mean gestational age of subjects was 26.8±2.6 weeks with a mean birthweight of 909±404 grams. The highest tertile (most deprived) of ADI was significantly associated with emer-gency department visits (aOR 1.72; p=0.009), hospital readmissions (aOR 1.66; p=0.030), and activi-ty limitations (aOR 1.55; p=0.048) compared to the lowest tertile. No association was seen with steroid, antibiotic or rescue medication use, trouble breathing, or nighttime symptoms. Conclusion: In this study, children with BPD who lived in neighborhoods of higher deprivation were more likely to be re-hospitalized and have ED visits for respiratory reasons. Identifying socio-environmental factors that contribute to adverse pulmonary outcomes in children with BPD may provide opportunities for earlier interventions to improve long-term pulmonary outcomes.
16 Feb 2022Submitted to Pediatric Pulmonology
17 Feb 2022Submission Checks Completed
17 Feb 2022Assigned to Editor
25 Feb 2022Reviewer(s) Assigned
04 Apr 2022Review(s) Completed, Editorial Evaluation Pending
04 Apr 2022Editorial Decision: Revise Major
15 Apr 20221st Revision Received
16 Apr 2022Submission Checks Completed
16 Apr 2022Assigned to Editor
16 Apr 2022Reviewer(s) Assigned
30 Apr 2022Review(s) Completed, Editorial Evaluation Pending
30 Apr 2022Editorial Decision: Revise Minor
03 May 20222nd Revision Received
04 May 2022Assigned to Editor
04 May 2022Submission Checks Completed
04 May 2022Reviewer(s) Assigned
06 May 2022Review(s) Completed, Editorial Evaluation Pending
07 May 2022Editorial Decision: Accept
21 May 2022Published in Pediatric Pulmonology. 10.1002/ppul.25969